Medical imaging apparatuses for acquiring a medical image through which a medical doctor checks or diagnoses the medical condition of a patient are known. A medical imaging apparatus can include one or a combination of various types of apparatus such as an X-ray imaging apparatus and an X-ray computed tomography (CT) apparatus using radiation, a magnetic resonance imaging (MRI) apparatus typified by an MRI, and a nuclear medicine imaging apparatus and an ultrasonic imaging apparatus typified by positron emission computerized-tomography (PET) and single photon emission computed tomography (SPECT). The medical images acquired by these medical imaging apparatuses may include various types of images such as a morphological image and one in which a functional value is imaged like a blood flow rate in the brain, for example. A medical doctor determines a required image according to the medical condition of a patient and carries out a diagnosis based on the image acquired by using a medical imaging apparatus accompanied by the determination of the doctor.
In recent years, medical imaging apparatuses can transfer information within an intra-hospital information system via a network to smoothly and accurately conduct an inspection using these medical imaging apparatuses. The intra-hospital information system includes a hospital information system (HIS) for managing information such as patient's information including patient name and patient ID, for example, and inspection request information including inspection date and imaged contents. In particular, the intra-hospital information system includes a radiology information system (RIS) for managing information such as patient's information and inspection request information in the department of radiology. To complement the intra-hospital information system, there exists an image storage and display apparatus whereby an acquired medical image is stored and displayed to be used for diagnosis. Digital Imaging and Communication in Medicine (DICOM) and Health Level Seven (HL7) are stipulated as standards for transmitting information between the intra-hospital information system and a medical imaging apparatus via a network.
The Integrated Healthcare Enterprise (IHE) initiative promotes integration of healthcare information resources to improve clinical care. In IHE, guidelines for promoting integration of the multi-vendors of the intra-hospital information systems have been proposed by unifying the method of using the DICOM and HL7 standards.
The outline of communication between the medical imaging apparatus and HIS/RIS during an inspection request (the issuance of an order) is described with reference to FIG. 22. FIG. 22 illustrates an example of a sequence diagram for transmitting inspection request information between the medical imaging apparatus and HIS/RIS.
As illustrated in FIG. 22, a medical imaging apparatus 100 requests inspection request information to a HIS/RIS 110 according to an instruction to acquire the inspection request information from an operator 120 using a search condition and acquires the inspection request information complying with the search condition. The medical imaging apparatus 100 analyzes the acquired inspection request information. The medical imaging apparatus 100 sends an inspection start notification according to an instruction to start inspection in which the operator 120 selects an inspection to be conducted from the acquired inspection request information. Then, the medical imaging apparatus 100 irradiates an object with X rays, for example, according to an instruction to execute the imaging operation from the operator 120 to acquire a medical image data. This process is repeated as required. The medical imaging apparatus 100 generates an inspection end notification according to an instruction to end the inspection from the operator 120 and notifies the HIS/RIS 110 of the end of the inspection.
In the execution of inspection in the case where a communication is made using the HIS/RIS 110, the medical imaging apparatus 100 notifies the HIS/RIS 110 of the start and end of inspection when the inspection is started or ended (including interruption). Thus, the HIS/RIS 110 can detect a state of execution of the medical imaging apparatus 100 in each inspection to be requested. The timing at which the medical imaging apparatus 100 notifies the HIS/RIS 110 of the start and end of inspection is determined by the operator 120 pressing inspection start or inspection end buttons, respectively, via a graphical user interface (GUI) on the medical imaging apparatus 100. Alternatively, for the notification of the end of inspection, the medical imaging apparatus 100 notifies the HIS/RIS 110 of the end of the previously conducted inspection at the timing at which the next inspection is started. This allows smoothly conducting various processes in the intra-hospital information system.
The information about the end of inspection of which the medical imaging apparatus 100 notifies the HIS/RIS 110 includes information about the number of captured images used for accounting for inspection. For example, if the operator 120 inadvertently leaves the medical imaging apparatus 100 as it is without issuing the instruction to end the inspection thereto, the medical imaging apparatus 100 does not notify the HIS/RIS 110 of the end of inspection. This causes a problem with the workflow such as incorrect or inaccurate accounting after the inspection. As remedies for solving such problems caused by the operator's failure in issuing the “end of inspection” instruction, there is discussed a technique in which ending conditions for ending the inspection are stored in advance into a medical imaging apparatus (refer to Japanese Patent Application Laid-Open No. 2007-215685, for example). Such a medical imaging apparatus automatically ends the inspection to be conducted at the timing at which the ending conditions are satisfied and notifies the HIS/RIS 110 of the end of inspection.
The medical imaging apparatus is capable of communicating with an image storage and display apparatus aside from the HIS/RIS as a imaging flow via a network. The image captured by the medical imaging apparatus is transferred to and stored in the image storage and display apparatus as a dedicated image storage server because the capacity of the medical imaging apparatus alone is insufficient to store the image. Typically, the medical imaging apparatus requests the image storage and display apparatus to store the image data by itself, and the image storage and display apparatus responds at the time when the image storage and display apparatus stores the image data. Such a process can ensure that the image data is properly stored in the image storage and display apparatus. The DICOM protocol stipulates the request for storage as “storage commitment.” The medical imaging apparatus may discard the stored image data by receiving the response from the image storage and display apparatus. Since the image storage and display apparatus includes a monitor whose definition is higher than that of a monitor of the medical imaging apparatus, the operator can examine an image with a higher definition by displaying the image data using an image viewer. The timing at which the medical imaging apparatus requests the image storage and display apparatus to store the image data is determined by the operator pressing inspection start or end buttons via the GUI on the medical imaging apparatus as is the case with the aforementioned notification of the end of inspection.
In the execution of inspection in the case where a communication is made using the above HIS/RIS, it is impossible to add a new inspection request to the inspection in which the medical imaging apparatus has once notified the HIS/RIS of the end of the inspection. FIG. 23 illustrates, as described below, that during communication between the medical imaging apparatus and the HIS/RIS, it is impossible to add a new (additional) inspection request.
As indicated in step S10 in FIG. 23, even if the medical imaging apparatus 100 generates an inspection end notification according to the instruction to end the inspection from the operator 120, it is possible to instruct the medical imaging apparatus 100 to add an additional imaging inspection unless the medical imaging apparatus 100 has notified the HIS/RIS 110 of the end of inspection. On the other hand, as indicated in step S20, if additional imaging inspection needs to be added after the medical imaging apparatus 100 has notified the HIS/RIS 110 of the end of inspection, it is impossible to instruct the medical imaging apparatus 100 to add the additional imaging inspection. For this reason, if inspection is conducted again, inspection request information needs to be generated again and an inspection request information notification needs to be received. In this case, however, the inspection needs to be repeated twice. Repetition on inspection represents a problem in that it increases patient burden.
For the medical imaging apparatus conforming to the DICOM standards, there is a method in which an Unscheduled Procedure Step P prepared for an unidentified patient urgently carried to hospital is used to conduct an additional inspection and integrate inspection information thereafter. In this case, it is essential for the medical imaging apparatus to conform to the DICOM standard, and integrating inspection information after inspection is performed may represent a problem in that a risk of inconsistency of data is increased.
On the other hand, as stated above, information about the number of captured images included in the end of inspection notification is used for accounting after inspection. Therefore, in the inspection taking a short time from the end of inspection to accounting such as the inspection for an outpatient, for example, it is required to transmit an end of inspection notification as quickly as possible after the inspection ends. For a group medical examination, for example, it is not required to transmit an end of inspection notification quickly because a plurality of patients takes a medical examination and accounting is collectively performed later in most cases. In other words, the timing at which the transmission of the end of inspection notification is required is different according to the type of inspection in a clinical site.
Complicatedness in inspection is greatly changed with contents to be imaged. The complicatedness in inspection is the greatest factor affecting the operator's mistake and misjudgment. If such a factor is solved by the conventional method of sending the end of inspection notification at the timing an inspection end button is pressed or the next inspection is started, a problem is caused in that the end of inspection end notification is not sent when accounting is requested or notification about the end of inspection desired to be added has been sent. Furthermore, since the end of inspection notification is sent at the same timing regardless of the complicatedness in inspection in all inspections, there is another problem that a follow-up to the operator is not realized on a complicated inspection high in necessity for the addition of inspection.